Diabetes is a disease characterized by an elevated level of glucose in the blood and in the urine. When blood sugar extremes—both high (hyperglycemia) and low (hypoglycemia)—are not treated, a patient can fall into a diabetic coma. The most common cause of diabetic coma is hypoglycemia. This is caused by excessive treatment with insulin relative to food intake and physical activity. Research indicates that the frequency of severe hypoglycemia is about 1.9 and 2.6 episodes per patient per year for Type 1 and Type 2 diabetes patients, respectively, with approximately 50% of these episodes occurring during sleep. There is evidence that the fear of a hypoglycemic episode significantly affects patient outcomes, such as glycemic control and management, self-treatment modifications, and post-episode lifestyle infringements (see Leiter et al. 2005, Canadian J. Diabetes; 29:186-192). Recent studies have indicated that about 30% of diabetic patients also have OSA (Meslier et al, Eur. Resp. J., 22(1):156-160), and there is emerging data indicating that effective treatment of OSA with n-CPAP significantly improves glucose metabolism.
Previously, treatments for diabetes usually have relied upon the either: regulating a patient's diet to limit the levels of glucose or fat ingested and/or monitoring and administering insulin or other pharmaceutical agents to control and regulate the glucose cycles in the body of a patient.
Systems have been described to detect and inform the patient or clinician of an imminent hypoglycemic or hyperglycemic event occurring within the patient due to poor regulation of the glucose pathways. These systems include the descriptions of: U.S. Pat. No. 7,160,252—Cho et al, U.S. Pat. No. 7,027,871—Burnes et al, and Patent Cooperation Treaty (PCT) Published Patent Application No. WO/2007/093010—Darkin et al.
Sleep-Disordered Breathing (SDB) is a general term for a sleep disorder with apneas and hypopneas. Obstructive Sleep Apnea (OSA) is an example of such a sleep disorder. Sullivan invented treatment of OSA with nasal Continuous Positive Airway Pressure (CPAP). See U.S. Pat. No. 4,944,310 (Sullivan). An apparatus for CPAP treatment typically includes: (i) a source of air at positive pressure, such as a servo-controlled blower, flow generator, or other positive airway pressure (PAP) device; (ii) an air delivery conduit; and (iii) a patient interface, such as a mask. The patient interface typically is connected to the patient with headgear including, for example, a series of elastic straps. At least a portion of the headgear is in contact with the patient's skin, typically on the patient's face. Patients wear the apparatus while sleeping.
A basic CPAP device may provide a supply of air at a generally fixed pressure in the range of 4-20 cmH2O. A more advanced CPAP device such as ResMed's AUTOSET SPIRIT™ can monitor the patient's breathing, determine the shape of the breath waveform, detect the presence of snoring, apneas, and hypopneas, and also adjust the treatment pressure. U.S. Pat. No. 5,704,345 to Berthon-Jones et al. describes this in detail. The entire contents of this patent are incorporated herein by reference.
Certain example embodiments of the present technology are directed towards improving patient outcomes with methods and apparatuses that can reduce the patients' fear of hypoglycemia and/or other diabetes-related events.